Outcomes 2 - Professional skills
We expect doctors to demonstrate appropriate skills in clinical practice.
Communication and interpersonal skills
10 Newly qualified doctors must be able to communicate effectively, openly and honestly with patients, their relatives, carers or other advocates, and with colleagues, applying patient confidentiality appropriately.
They must be able to:
- Communicate clearly, sensitively and effectively with patients, their relatives, carers or other advocates, and colleagues from medical and other professions, by:
- listening, sharing and responding
- demonstrating empathy and compassion
- demonstrating effective verbal and non-verbal interpersonal skills
- making adjustments to their communication approach if needed, for example for people who communicate differently due to a disability or who speak a different first language
- seeking support from colleagues for assistance with communication if needed.
- where there is conflict or disagreement
- when sharing news about a patient's condition that may be emotionally challenging for the patient and those close to them
- when sharing news about a patient's death with relatives and carers or other advocates
- when discussing issues that may be sensitive for the patient, such as alcohol consumption, smoking, diet and weight management or sexual behaviour
- when communicating with people who lack insight into their illness or are ambivalent about treatment
- when communicating with children and young people
- when communicating with people who have impaired hearing, language, speech or sight
- when communicating with people who have cognitive impairment
- when communicating with people who have learning disabilities
- when English is not the patient's first language - by using an interpreter, translation service or other online methods of translation
- when the patient lacks capacity to reach or communicate a decision on their care needs
- when advocating for patients' needs
- when making referrals to colleagues from medical and other professions
- when providing care remotely, such as carrying out consultations using telecommunications.
11 Newly qualified doctors must be able to carry out an effective consultation with a patient.
They must be able to:
- Elicit and accurately record a patient's medical history, including family and social history, working with parents and carers or other advocates when the patient is a child or young person or an adult who requires the support of a carer or other advocate
- Encourage patients' questions, discuss their understanding of their condition and treatment options, and take into account their ideas concerns, expectations, values and preferences
- Acknowledge and discuss information patients have gathered about their conditions and symptoms, taking a collaborative approach
- Provide explanation, advice and support that matches patients' level of understanding and needs, making reasonable adjustments to facilitate patients' understanding if necessary
- Assess a patient's capacity to understand and retain information and to make a particular decision, making reasonable adjustments to support their decision making if necessary, in accordance with legal requirements in the relevant jurisdiction and the GMC's ethical guidance as appropriate
- Work with patients, or their legal advocates, to agree how they want to be involved in decision making about their care and treatment
- Describe the principles of holding a fitness for work conversation with patients, including assessing social, physical, psychological and biological factors supporting the functional capacity of the patient, and how to make referrals to colleagues and other agencies.
Diagnosis and medical management
12 Newly qualified doctors must work collaboratively with patients and colleagues to diagnose and manage clinical presentations safely in community, primary and secondary care settings and in patients’ homes. Newly qualified doctors must, wherever possible, support and facilitate patients to make decisions about their care and management.
13 Newly qualified doctors must be able to perform the core set of practical skills and procedures safely and effectively, and identify, according to their level of skill and experience, the procedures for which they need supervision to ensure patient safety.
15 Newly qualified doctors must demonstrate that they can make appropriate clinical judgements when considering or providing compassionate interventions or support for patients who are nearing or at the end of life. They must understand the need to involve patients, their relatives, carers or other advocates in management decisions, making referrals and seeking advice from colleagues as appropriate.
16 Newly qualified doctors must be able to give immediate care to adults, children and young people in medical and psychiatric emergencies and seek support from colleagues if necessary.
17 Newly qualified doctors must be able to recognise when a patient is deteriorating and take appropriate action.
They must be able to:
- Assess and determine the severity of a clinical presentation and the need for immediate emergency care
- Diagnose and manage acute medical and psychiatric emergencies, escalating appropriately to colleagues for assistance and advice
- Provide immediate life support
- Provide cardiopulmonary resuscitation.
Prescribing medicines safely
18 Newly qualified doctors must be able to prescribe medications safely, appropriately, effectively and economically and be aware of the common causes and consequences of prescribing errors.
They must be able to:
- Establish an accurate medication history, covering both prescribed medication and other drugs or supplements, and establish medication allergies and the types of medication interactions that patients experience
- Carry out an assessment of benefit and risk for the patient of starting a new medication taking into account the medication history and potential medication interactions in collaboration with the patient and, if appropriate, their relatives, carers or other advocates
- Provide patients, their relatives, carers or other advocates, with appropriate information about their medications in a way that enables patients to make decisions about the medications they take
- Agree a medication plan with the patient that they are willing and able to follow
- Access reliable information about medications and be able to use the different technologies used to support prescribing
- Calculate safe and appropriate medication doses and record the outcome accurately
- Write a safe and legal prescription, tailored to the specific needs of individual patients, using either paper or electronic systems and using decision support tools where necessary
- Describe the role of clinical pharmacologists and pharmacists in making decisions about medications and prescribe in consultation with these and other colleagues as appropriate
- Communicate appropriate information to patients about what their medication is for, when and for how long to take it, what benefits to expect, any important adverse effects that may occur and what follow-up will be required
- Detect and report adverse medication reactions and therapeutic interactions and react appropriately by stopping or changing medication
- Monitor the efficacy and effects of medication and with appropriate advice from colleagues, reacting appropriately by adjusting medication, including stopping medication with due support, care and attention if it proves ineffective, is no longer needed or the patient wishes to stop taking it
- Recognise the challenges of safe prescribing for patients with long term physical and mental conditions or multiple morbidities and medications, in pregnancy, at extremes of age and at the end of life
- Respect patient choices about the use of complementary therapies, and have a working knowledge of the existence and range of these therapies, why patients use them, and how this might affect the safety of other types of treatment that patients receive
- Recognise the challenges of delivering these standards of care when prescribing and providing treatment and advice remotely, for example via online services
- Recognise the risks of over-prescribing and excessive use of medications and apply these principles to prescribing practice.
Using information effectively and safely
19 Newly qualified doctors must be able to use information effectively and safely in a medical context, and maintain accurate, legible, contemporaneous and comprehensive medical records.
They must be able to:
- Make effective use of decision making and diagnostic technologies
- Apply the requirements of confidentiality and data protection legislation and comply with local information governance and storage procedures when recording and coding patient information
- Explain their professional and legal responsibilities when accessing information sources in relation to patient care, health promotion, giving advice and information to patients, and research and education
- Discuss the role of doctors in contributing to the collection and analysis of patient data at a population level to identify trends in wellbeing, disease and treatment, and to improve healthcare and healthcare system
- Apply the principles of health informatics to medical practice.